FIRST AID
FOR BASEBALL COACHES
John K. Murphy, PA-C, JD
GOALS
• This course is designed to instruct coach
very basic first aid techniques to protect
the players under your guidance.
• This presentation only provides a brief
overview of the issues that you may face
during the time you are with these players.
• Recommend – 8 hour First Aid & CPR
Course
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LEGAL PROTECTION
• Good Samaritan Law RCW 4.24.300
– Qualified Immunity from liability for certain types of medical
care.
– Any person, including but not limited to a volunteer provider of
emergency or medical services, who without compensation or
the expectation of compensation renders emergency care at the
scene of an emergency or who participates in transporting, not
for compensation, therefrom an injured person or persons for
emergency medical treatment shall not be liable for civil
damages resulting from any act or omission in the rendering of
such emergency care or in transporting such persons, other
than acts or omissions constituting gross negligence or
willful or wanton misconduct.
AED
Defibrillation
• RCW 70.54.310
– Law outlines the rules associated with the acquisition,
training, requirement of medical direction from a
licensed physician, maintenance, notification of
emergency medical service of the ownership of such
equipment and notification of 911 after the use of this
equipment.
– The law also provides a limited immunity for civil
liability associated with the user of the equipment, but
specifically restricts immunity based on gross
negligence.
Zachery Lystedt Law
RCW 28A.600.190
• Youth athletes who are suspected of sustaining a concussion or
head injury be removed from play. "When in doubt, sit them out"
• School districts to work with the Washington Interscholastic
Activities Association (WIAA) to develop information and policies on
educating coaches, youth athletes and parents about the nature and
risk of concussion, including the dangers of returning to practice or
competition after a concussion or head injury.
• All student athletes and their parents/guardians sign an information
sheet about concussion and head injury prior to the youth athlete's
initiating practice at the start of each season.
• Youth athletes who have been removed from play receive written
medical clearance prior to returning to play from a licensed healthcare provider trained in the evaluation and management of
concussion.
• Private, nonprofit youth sports associations wanting to use
publicly owned playfields comply with this law.
Concussion signs observed include:
• Appears dazed
• Vacant facial expression
• Confused about
assignment
• Forgets plays, positions
or past immediate
performance
• Is unsure of game, score,
or opponent
• Moves clumsily or
displays lack of
coordination
• Answers questions slowly
• Slurred speech
• Shows behavior or
personality changes
• Can’t recall events prior
to hit
• Can’t recall events after
hit
• Seizures or convulsions
• Any change in typical
behavior or personality
• Loses consciousness
Late symptoms of concussion may
include one or more of the following:
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** Unconsciousness
** Nausea or vomiting
Balance problems or dizziness
Blurred, double, or fuzzy vision
Pressure in head
Neck pain Sensitivity to light or
noise
Feeling sluggish or slowed
down
Feeling foggy or groggy
Drowsiness
Repeating the same
question/comment
•
•
•
•
•
•
•
•
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Change in sleep patterns
Amnesia
“Don’t feel right”
Fatigue or low energy
Sadness
Nervousness or anxiety
Irritability
More emotional
Confusion
Concentration or memory
problems (forgetting game
plays)
IMMEDIATE TREATMENT
• Remove from play
• Have child evaluated by qualified Health
Care provider
– MD, DO, PA, Trainer, ARNP
• Generally observe at home
– Any change in signs and Symptoms,
immediate return to Emergency Room or
Health Care Practitioner
Coach Pleads Not Guilty to
Reckless Homicide
January 2009
•
Football player collapsed from heat stroke during the Aug. 20 practice in the
sweltering Kentucky heat and died three days later. Withheld water from players
– Core temperature reported at 107 degrees
•
The family of the 15-year-old football player sued the coaching staff to bring
awareness to hydration and heat-related illnesses so that "maybe this won't happen
again," the boy's stepmother told "Good Morning America"
•
The head football coach pleaded not guilty to charges of reckless homicide.
– Reckless Homicide - Consciously disregarding a known and substantial risk of
harm
•
Criminal Trial – Ended September 2009 – Acquitted
•
Civil Trial – Family sues – Trial Scheduled 2010
----- continued
• All the coaches were named in a civil lawsuit by
Gilpin's parents, accusing the coaches of
negligence and "reckless disregard."
• Gilpin’s parents have filed a civil suit against
Stinson and several other school officials.
• Washington State has a wrongful death statute
which allows surviving relatives such as a
parent, spouse or child to bring a civil suit on
behalf of their deceased loved one.
– In wrongful death cases, the family of the deceased
may recover damages against the person whose
negligence caused the family member's death
SOME IMPORTANT PRINCIPLES
WHILE COACHING
•
•
First - DO-NO-HARM
The short person under your care is a child
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–
•
Kids get injured
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•
•
Do not treat them as professional athletes
Having fun is the primary priority
The LOUDER a child cries the less injury they sustained
The QUIET ones are the one that should worry you
Most injuries are minor and can be treated with
simple measures
It will be highly UNLIKELY that you will encounter
a life threatening injury
BASIC PRINCIPLES OF
FIRST AID
•
A, B, C, D – CALL 911
–
Airway
•
–
Breathing
•
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Look for obstruction – gum or tobacco –
sometimes food
Circulation
•
•
–
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Open and listen for air exchange
Create a circulation
Control bleeding
Defibrillation if necessary
Call – 911
HEAD AND NECK
– HEAD - Skull Fractures or facial injuries
• Depressed or Penetrating
• Concussion
– Eye Injuries
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–
–
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Foreign bodies
Fingers into the eye
Corneal Abrasions/lacerations
Struck by ball
– Teeth Injuries
– Chipped or loose teeth – see dentist as soon as possible
– Tooth displaced - Keep the tooth
– Try to re-implant if you have the whole tooth plus the root structure
» MAKE SURE IT POINTS THE RIGHT WAY
– Place in a cup of milk and have the parent transport to their dentist or the ER
– Tuck tooth in-between cheek an gum – transport to dentist or ER
– NOSE – Fractures
• Bleed a lot
• Direct Pressure on the sides (bridge) of the nose controls bleeding
• Ice
• Seek medical attention
HEAD AND NECK
– NECK - Neck Injuries
• Stabilize head with hand stabilization
• Obstructed Airway’s need to be cleared
• Do not manipulate the head
• Significant Neck Injury
– Numbness, burning sensation
– inability to move lower extremities
– NEUROLOGIC
• Epileptic
– Head Trauma Induced
• High internal temperatures
– Environmental caused
• Low Blood Sugar
– Diabetic?
• Current Medical Condition?
CHEST AND ABDOMEN
– CHEST - Chest Trauma
• Rib Fractures
• Respiratory Distress
• Respiratory Arrest
– CARDIAC ARREST - Hit by pitched ball in the chest
• Heart operates on electrical discharge
• Cardiac Contusions
• Pre-disposition with a hidden or occult cardiac defect
– ABDOMEN - Abdominal Injuries
• Spleen
• Liver
• Penetrating Injuries
---- continued
– RESPIRATORY EMERGENCIES
• Asthma
• Allergic Reactions
– Bee Stings
– Peanuts
• Epi Pens
ARMS AND LEGS
Fingers and Toes
– SKELETAL - Fractures
• Fractures
– Management – splint, ice and transport
• Sprains and Strains
– Sprain involves the ligaments supporting a joint
» Ligaments attach bone to bone
– Strains involves muscles and tendons
» Tendons anchor muscles to bone
Sprains
Ice Compression Elevation (ICE)
Fractures
Splint & Ice, Compression, Elevation (ICE)
SKIN
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Contusions
Abrasions
Lacerations
Punctures
EVERYTHING ELSE
– ENVIRONMENTAL
• Dehydration
– Periodic Rest and Fluid Replacement
• Hypothermia
– Low body temperature – warm and dry
• Hyperthermia
– High Body Temperature
» Heat Exhaustion – stopped sweating – increase body
temperature
» Heat Stroke – high body temperature, unconsciousness
and possible seizures
• Sunburn
– Treat with Aspirin (internally) and White Vinegar (externally)
INITIAL INJURY MANAGEMENT
• Airway Breathing Circulation – if child is
laying on ground resist the urge to pick
them up
• Opening and maintaining an airway;
• Breathing for the ill or injured persons;
• Check for Circulation
– Administering cardiopulmonary
resuscitation
----- continued
• Provide first aid for simple and multiple system
trauma
– Controlling bleeding,
– Bandaging wounds,
– Manually stabilizing injured extremities.
• Liberal Application of ICE on Sprains & Strains
– ICE = Ice, Compression, Elevation
– Real Ice or Chemical Packs?
ACCESS EMS SYSTEM
911 – know your location
• Call 911 for the following
– Cardiac or respiratory arrest
– Difficulty in breathing
– Uncontrolled bleeding
– Fractures that stick through the skin
– Unconsciousness
– Seizures
– Allergic Reaction
– Things poking out of - or into them
REPORTING THE INCIDENT
• Liability Issues.
– Do the right thing
– State provides qualified immunity
• Provide written documentation to league
as per league protocol.
– Incident Reporting Form
•
•
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Name
Incident
Treatment
Disposition
BIOLOGIC - INFECTIOUS
DISEASE PROTECTION
• If it is wet and not yours, don’t
touch it
– Wash your hands after treating bloody or
snotty kids
• Lots of product on the market
– Wear gloves if available
– Don’t freak out if you get blood or body fluid
on your skin
• Transmission of infectious disease is remote
through intact skin
Play or Not Play
•
•
•
This is a decision that you should make
after evaluation of the child’s injury.
The safe course is to have them sit out
for a period of time.
DO NOT be influenced by parental
desire for “Johnny or Janie” to gut it out
– “no blood no foul” is not the rule of
the day
First Aid Kit Essentials
• Band-Aids
• Tape 1” or 1.5 inch
• Ice Packs – Ziploc bags
or chemical
• Splinting Material
– Newspapers
– Magazines
• Disposable gloves
• Paper Cups
• 4x4 gauze pads
• 2” or 3” Gauze Wrap
• Small Water bottles
– Washing off cuts and
scrapes
– Irrigating the eye
• Antibiotic Ointment
– Neosporin
• Safety Scissors
• Tweezers
• Cell Phone
And if all else fails
THANK YOU FOR ALL
THAT YOU DO
PLEASE FEEL FREE TO CONTACT ME
IF YOU HAVE A MEDICAL OR LEGAL
QUESTION AT:
j.k.murphy@comcast.net
OR CALL
206-940-6502